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Affordable Care Act -- NOT Affordable


yinne
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Poppycock. Go to the major cancer treatment providers' webpages and find out reality.

 

MD Anderson alone treated over 45,000 people and wrote off $215million for those who had no insurance or were underinsured in 2011.

Actually my mother was told she could not have her chemo and radiation treatments unless she paid her bill and she had insurance! She did not get treatment at MD Anderson and could not afford to travel there if she wanted to. I wager that most places do not give write off chemo and radiation treatments to a great extent since they are not legally obliged to do so. Emergency rooms only have to stabilize someone and do not provide chemo and radiation or treatments and medications needed for chronic care which can cost thousands of dollars each month.

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Ok. Can someone take pity on me and help me with this? I swear I'm a smart person, I just truly don't understand. I've never had health insurance before. I live in a state that's not expanding Medicaid, fwiw.

 

So if we have a family of 4 making $25000 a year, how much will I pay upfront? Will I pay for drs visits and copayment?

 

 

I think you will qualify for the catastrophic plan for those under 30 and low income.  But I am just as confused as you. 

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Ok. Can someone take pity on me and help me with this? I swear I'm a smart person, I just truly don't understand. I've never had health insurance before. I live in a state that's not expanding Medicaid, fwiw.

 

So if we have a family of 4 making $25000 a year, how much will I pay upfront? Will I pay for drs visits and copayment?

 

I went to this website and plugged in some numbers   http://kff.org/interactive/subsidy-calculator/

I don't know your ages and if you smoke, but you can enter numbers and see what it gives you.    Remember it is just a ballpark.

 

Results

Note that regardless of whether your state expands Medicaid, children at this income under the age of 19 are likely eligible for coverage under Medicaid or the Children's Health Insurance Program (CHIP), depending on your state's eligibility requirements.

 

If your state expands Medicaid

If your state chooses to expand Medicaid to everyone under 138% of the poverty level under the ACA, you will be eligible for coverage under the program. Medicaid coverage varies from state to state, but out-of-pocket costs are generally modest. Smoking status is not taken into account in Medicaid eligibility.

 

If your state does not expand Medicaid

If your state does not expand Medicaid, you will be eligible to purchase subsidized coverage through the exchanges.

The information below is about subsidized exchange coverage. Note that depending on your state's eligibility requirements, you may still be eligible for coverage through Medicaid.

 

Household income in 2014: 106% of poverty level

Unsubsidized annual health insurance premium in 2014: $10,612

Maximum % of income you have to pay for the non-tobacco premium, if eligible for a subsidy: 2%

Amount you pay for the premium: $500 per year (which equals 2% of your household income and covers 5% of the overall premium)

You could receive a government tax credit subsidy of up to: $10,112  (which covers 95% of the overall premium)

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I'm glad your costs have gone down, but I can honestly say IRL I don't know of anyone whose employer costs have gone down for the same or better coverage.  Most have less coverage and have started to ask employees to cover some of it either monthly or through co-payments.  Others have the same with the employer eating the extra costs.  Still others have lost employer covered insurance (these have all been small businesses or gov't entities like our township).

 

Maybe it depends upon which state one is in...

Health insurance costs have been rising for decades and plans have gotten skimpier for decades as well. I worked in a hospital for over 20 years and the CEO told the employees many years way back in the 1990s and early 2000s about how the insurance companies were raising the rates 20 to 50% which increased the premiums the employees paid and made the plans skimpier and skimpier every year. I distinctly remember this.

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That's what I thought too, but my husband will be over 30. Do we get separate plans I wonder..

 

 

Oh I thought it was either 30 or under a certain income....didn't realize it had to be both.  I am really confused.

 

I am trying to stay calm until the exchange opens.  I am OK, which has apparently opted out of the exchange and is suing the Feds over it.  So I am sure it will be a big fat mess.

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Health insurance costs have been rising for decades and plans have gotten skimpier for decades as well. I worked in a hospital for over 20 years and the CEO told the employees many years way back in the 1990s and early 2000s about how the insurance companies were raising the rates 20 to 50% which increased the premiums the employees paid and made the plans skimpier and skimpier every year. I distinctly remember this.

 

 

Not all of us experienced any of this until this year, though. Our insurance for the past 13 years was awesome and the premiums were low. This year our premiums jumped and our coverage is horrible. We cannot afford to use it.

 

I needed a repeat mammogram six months ago (the first I had under our insurance last year when it was still awesome), but I cannot afford it. Dh needs a cardiologist and cannot afford it. We have never had any trouble paying a doctor or bill for the past 13 years and now this year we can't afford the out of pocket expenses for anything.

 

 

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some of you seem to have a grip on this insurance stuff......

 

If either of us (me and hubby) have the opportunity to get insurance through either of our employers, then we can NOT get insurance through the exchange?? yes ? No ?  

 

And only if you get insurance through the exchange do you get the subsidy?  

 

cause we can't afford the insurance through either without a subsidy.....

 

Just wondering if I even have a chance at the exchange and the subsidy..... or we just have to continue to go without insurance and now get to pay for that privilege.

 

If it is above 9% of our income though we can get a waiver, is that right and not have to have insurance or the fine??

 

how does it work when both spouses have jobs and have employer insurance offers? Do they combine our household income? Or take it at each individual ?  So my hubby's plan might be 12% of his income and mine is say 8% of my income?   How does that work?? Combine our totals and then pick an employer 's plan to get the percentage of income?

 

I'm so confused.   Our state isn't expanding medicaid and isn't even setting up the exchange. We are going through the federal exchange as a state.

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YIKES! I read the FAQ and found out I entered our info incorrectly... I just used our (adult) combined income. I'd have to add in youngest's too... and silly me thought he was working for college $$.

 

The silver plan only covers at 70% on top of it all. (Bronze 60%)

 

Yuck, yuck, yuck. How did ANYONE think this was a good deal?

Do we have to include a 23 year old who is not living at home, but who is currently on our healthcare plan?

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See this is something I think a lot of people don't think about.  DH once worked for a company that offered what I considered excellent and affordable insurance.  But they had 2 aspects to the business.  Basically corporate/engineering and production.  The production people were paid far less.  So for some of them the "affordable" insurance was too expensive.  I thought it was unfair.  To me they should have had a sliding scale based on salary.  

 

My employer has a sliding scale based on income.  I have a high deductible (which isn't high - $1200) plan, carry two adults on my policy, and get $1400 deposited into my HSA every year.  I pay $50 a month.  Yes, I have really good benefits!

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I went to this website and plugged in some numbers   http://kff.org/interactive/subsidy-calculator/

I don't know your ages and if you smoke, but you can enter numbers and see what it gives you.    Remember it is just a ballpark.

 

Results

Note that regardless of whether your state expands Medicaid, children at this income under the age of 19 are likely eligible for coverage under Medicaid or the Children's Health Insurance Program (CHIP), depending on your state's eligibility requirements.

 

If your state expands Medicaid

If your state chooses to expand Medicaid to everyone under 138% of the poverty level under the ACA, you will be eligible for coverage under the program. Medicaid coverage varies from state to state, but out-of-pocket costs are generally modest. Smoking status is not taken into account in Medicaid eligibility.

 

If your state does not expand Medicaid

If your state does not expand Medicaid, you will be eligible to purchase subsidized coverage through the exchanges.

The information below is about subsidized exchange coverage. Note that depending on your state's eligibility requirements, you may still be eligible for coverage through Medicaid.

 

Household income in 2014: 106% of poverty level

Unsubsidized annual health insurance premium in 2014: $10,612

Maximum % of income you have to pay for the non-tobacco premium, if eligible for a subsidy: 2%

Amount you pay for the premium: $500 per year (which equals 2% of your household income and covers 5% of the overall premium)

You could receive a government tax credit subsidy of up to: $10,112  (which covers 95% of the overall premium)

Don't forget the out of pocket costs afterward if something actually is wrong... Putting in the same info (25K, family of 4, but not knowing ages or tobacco use), then scrolling down, the out of pocket costs can be $4500 annually in the form of co-pays.  The silver plan (the one quoted) has the $4500 out of pocket, but pays at 94% (not bad actually). The bronze plan (which would be free with subsidizes) only pays at 60% and "could have higher out of pocket costs."

 

At least by being 2% of income, this would generally be considered affordable.  Ours approaches the upper end of possibilities (and still get subsidizes) at 9.5% with $12,700 possible in addition to the costs.  I still haven't added in youngest's income either.  Since we don't need to go this route (I like my $370/month with the health sharing) I'm merely following this out of curiosity at this point.

 

Health insurance costs have been rising for decades and plans have gotten skimpier for decades as well. I worked in a hospital for over 20 years and the CEO told the employees many years way back in the 1990s and early 2000s about how the insurance companies were raising the rates 20 to 50% which increased the premiums the employees paid and made the plans skimpier and skimpier every year. I distinctly remember this.

Definitely true, but nowhere near the levels it's at now.  I've been at work for 14 years now and in this area for 17 years.  I'm not sure what happened in our circle of friends prior to that.  I do know we went with health sharing somewhere between 10 and 14 years ago when hubby started his own business and our insurance was too high for us to pay (at $600/month).  We started with insurance not knowing there was another option, then switched when they raised the rate and we started looking around.  To be fair, the health sharing cost went up over those years too.  I believe we started at $250/month and it's now at $370/month for the family rate.  Health care costs have gone up (and there's been inflation).  No one disputes that.  It's still nothing like what several have seen locally lately.

 

Do we have to include a 23 year old who is not living at home, but who is currently on our healthcare plan?

Here's what the FAQ say about it:

 

"Household income includes incomes of the taxpayer, spouse, and dependents. In determining eligibility for exchange subsidies, income will be based on your attestation of your expected income in 2014 and will be verified by the exchange with documentation from your most recent tax return, with consideration of reasonable changes you expect. Exchanges will calculate enrollees’ household incomes using Modified Adjusted Gross Income, or MAGI.  The MAGI calculation includes such income sources as wages, salary, foreign income, interest, dividends, and Social Security. MAGI calculation does not include income from gifts, inheritance, and Survivors Benefits, and some other income sources are partially excluded."

 

I would guess yes.  Anything anyone who is on the policy makes gets counted.  It's probably best to split up in your situation (if possible).

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See this is something I think a lot of people don't think about. DH once worked for a company that offered what I considered excellent and affordable insurance. But they had 2 aspects to the business. Basically corporate/engineering and production. The production people were paid far less. So for some of them the "affordable" insurance was too expensive. I thought it was unfair. To me they should have had a sliding scale based on salary.

And on the flip side, my husband's company subsidizes insurance for those who make under $50k and does nothing for those who make over. When he was making $51 k, he took home significantly less than the people who had lower salaries than him. Seems kind of crazy.

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Health insurance costs have been rising for decades and plans have gotten skimpier for decades as well. I worked in a hospital for over 20 years and the CEO told the employees many years way back in the 1990s and early 2000s about how the insurance companies were raising the rates 20 to 50% which increased the premiums the employees paid and made the plans skimpier and skimpier every year. I distinctly remember this.

Um, yeah. I'm sure the new increases have nothing to do with the ACA.

 

Come on! The middle class is subsidizing insurance for the millions who don't have it. You may be for or against that, but at least admit that it will have an affect on premiums for those who have been able to afford insurance in the past.

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See this is something I think a lot of people don't think about.  DH once worked for a company that offered what I considered excellent and affordable insurance.  But they had 2 aspects to the business.  Basically corporate/engineering and production.  The production people were paid far less.  So for some of them the "affordable" insurance was too expensive.  I thought it was unfair.  To me they should have had a sliding scale based on salary.  

 

My DH's employer has a sliding scale.  The salaried employees pay more for the same coverage that the hourly workers get for significantly less.  I *believe* it was actually couched in the terms of "those who make more will pay a bit larger share so that those who make less won't have to pay so much."  Not an exact quote, but that was more or less how it was presented.  I have to say that liberal/progressive as I am, it stung a bit to know that because my DH worked long and hard to get his education and has worked a long time in his field, some of his money was going to pay for the insurance coverage of the 18-yo maybe high school dropout working in the shipping department.  But the more compassionate part of me was happy that person would have good insurance.

 

 

Come on! The middle class is subsidizing insurance for the millions who don't have it. You may be for or against that, but at least admit that it will have an affect on premiums for those who have been able to afford insurance in the past.

 

In theory having those people on the insurance rolls will eventually cause premiums to decrease.  Of course the jury's still a long way out on whether or not that will work.  We can debate it till the cows come home, but no one really knows if it will work or not.

 

 

 

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Don't forget the out of pocket costs afterward if something actually is wrong... Putting in the same info (25K, family of 4, but not knowing ages or tobacco use), then scrolling down, the out of pocket costs can be $4500 annually in the form of co-pays. The silver plan (the one quoted) has the $4500 out of pocket, but pays at 94% (not bad actually). The bronze plan (which would be free with subsidizes) only pays at 60% and "could have higher out of pocket costs."

 

At least by being 2% of income, this would generally be considered affordable. Ours approaches the upper end of possibilities (and still get subsidizes) at 9.5% with $12,700 possible in addition to the costs. I still haven't added in youngest's income either. Since we don't need to go this route (I like my $370/month with the health sharing) I'm merely following this out of curiosity at this point.

 

Definitely true, but nowhere near the levels it's at now. I've been at work for 14 years now and in this area for 17 years. I'm not sure what happened in our circle of friends prior to that. I do know we went with health sharing somewhere between 10 and 14 years ago when hubby started his own business and our insurance was too high for us to pay (at $600/month). We started with insurance not knowing there was another option, then switched when they raised the rate and we started looking around. To be fair, the health sharing cost went up over those years too. I believe we started at $250/month and it's now at $370/month for the family rate. Health care costs have gone up (and there's been inflation). No one disputes that. It's still nothing like what several have seen locally lately.

 

Here's what the FAQ say about it:

 

"Household income includes incomes of the taxpayer, spouse, and dependents. In determining eligibility for exchange subsidies, income will be based on your attestation of your expected income in 2014 and will be verified by the exchange with documentation from your most recent tax return, with consideration of reasonable changes you expect. Exchanges will calculate enrollees’ household incomes using Modified Adjusted Gross Income, or MAGI. The MAGI calculation includes such income sources as wages, salary, foreign income, interest, dividends, and Social Security. MAGI calculation does not include income from gifts, inheritance, and Survivors Benefits, and some other income sources are partially excluded."

 

I would guess yes. Anything anyone who is on the policy makes gets counted. It's probably best to split up in your situation (if possible).

She doesn't live with us and is no longer our dependent, so that actually makes me think we wouldn't include her income.

 

But if we wanted to split into separate policies, it's not clear to me that we could even do that.

 

Nothing is clear, actually. The main thing that gets my blood pressure up is my husband's employer said we would be paying 60% of our salary to insurance in the near future. That takes us from being able to live well, to not being able to afford the basics. My husband works 12 hours a day and many weekends. I hardly see him. It seems like if we are going to lose over half his salary, he should just take a low paying job. I don't see how this can possibly be? I am for helping the poor, but not if it means my family is now barely able to get by.

 

I'd also love to know what kind of coverage is offered through the subsidies. If you get cancer and you have the 60% plan, bankruptcy would still be a real possibility. I hate all the focus on routine care, because that is affordable for many people. Treating cancer or a preemie, not so much. The main thing I always look at in a health insurance policy is the cap.

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My DH's employer has a sliding scale. The salaried employees pay more for the same coverage that the hourly workers get for significantly less. I *believe* it was actually couched in the terms of "those who make more will pay a bit larger share so that those who make less won't have to pay so much." Not an exact quote, but that was more or less how it was presented. I have to say that liberal/progressive as I am, it stung a bit to know that because my DH worked long and hard to get his education and has worked a long time in his field, some of his money was going to pay for the insurance coverage of the 18-yo maybe high school dropout working in the shipping department. But the more compassionate part of me was happy that person would have good insurance.

 

 

 

In theory having those people on the insurance rolls will eventually cause premiums to decrease. Of course the jury's still a long way out on whether or not that will work. We can debate it till the cows come home, but no one really knows if it will work or not.

 

 

I was willing to subscribe to that theory until I read in the paper the other day that half of the country's uninsured will pay $57 a month and will receive tax credits. To me, that just gives the illusion that they are paying insurance.

 

But, you are right. We will not know until it happens. Like I said above, the thing that really scares me is that my dh's employer said that we will soon be paying 60% of his salary towards insurance. That seems unbelievable. I will be glad when I know what we are truly facing.

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She doesn't live with us and is no longer our dependent, so that actually makes me think we wouldn't include her income.

 

But if we wanted to split into separate policies, it's not clear to me that we could even do that.

 

Nothing is clear, actually. The main thing that gets my blood pressure up is my husband's employer said we would be paying 60% of our salary to insurance in the near future. That takes us from being able to live well, to not being able to afford the basics. My husband works 12 hours a day and many weekends. I hardly see him. It seems like if we are going to lose over half his salary, he should just take a low paying job. I don't see how this can possibly be? I am for helping the poor, but not if it means my family is now barely able to get by.

 

I'd also love to know what kind of coverage is offered through the subsidies. If you get cancer and you have the 60% plan, bankruptcy would still be a real possibility. I hate all the focus on routine care, because that is affordable for many people. Treating cancer or a preemie, not so much. The main thing I always look at in a health insurance policy is the cap.

I'm still thinking if she's on the plan, her income gets counted - you'd just put 3 adults in rather than 2 adults and 1 child (since she's an adult).  I doubt they'd count a teen's income and not an adults if they were all on the same plan.  It says nothing about having to live under the same roof.

 

BUT, if you get insurance from your employer, you aren't eligible for any of this from what I'm reading.  One of the questions asked if you can get insurance from your employer.

 

I could be wrong.  I'm definitely not an expert.  I'm just reading what's on that link Cathie originally posted.  I've never actually cared much about ACA before since it doesn't affect us.

 

I do want to see all have medical care... I feel health care should be affordable to all, but I'll admit to thinking this isn't the best way to do it now that I see how numbers are working out for so many folks around me IRL and on this board otherwise. 

 

I guess I'm in the single payer - non-profit - mode with options for folks to pay for more/better/different if they prefer.  How to pay for the basic?  I'm not sure.  I guess that's the big question.  I might actually vote for a national sales tax slated solely for this, but I'd have to think about it and consider other options proposed.

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I just want to note that all of these calculators are hot air. Not a single one of them are factual because none of the exchanges open up until October 1. At best, they are optimistic guestimates. On that date, you can go to the federal website, choose your state, put in your info and get supposedly accurate info. If the system doesn't crash from so many doing the same thing.

 

So don't base anything on those calculators. Wait and see.

 

As for us, we will not be joining. We just don't have any money to spare regardless of what the govt says we can afford. In theory we are on expanded Medicaid in Oklahoma, but it's almost useless. I have not been able to use it even once in the last year except for RX. (Now for rx? That is great!) Because the few doctors on it aren't accepting new patients and even if we were to get on their waitlist, the wait to actually be seen is ridiculously long. We have been paying out of pocket as uninsured for every single doctor appoint this year because of one or both of those factors. On the plus side, we have gotten quicker and better care because of it, but hello debt and sad for those who just wait or do without or go to the ER. :/

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I was willing to subscribe to that theory until I read in the paper the other day that half of the country's uninsured will pay $57 a month and will receive tax credits. To me, that just gives the illusion that they are paying insurance.

 

But, you are right. We will not know until it happens. Like I said above, the thing that really scares me is that my dh's employer said that we will soon be paying 60% of his salary towards insurance. That seems unbelievable. I will be glad when I know what we are truly facing.

Sounds like scare tactics to me. Even deadbeat dads can't be forced to pay over a certain percentage of their pay to catch up when they are behind.

 

If someone would tell me I have to pay 60% of our income for health insurance I would laugh.

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I just want to note that all of these calculators are hot air. Not a single one of them are factual because none of the exchanges open up until October 1. At best, they are optimistic guestimates. On that date, you can go to the federal website, choose your state, put in your info and get supposedly accurate info. If the system doesn't crash from so many doing the same thing.

 

So don't base anything on those calculators. Wait and see.

 

As for us, we will not be joining. We just don't have any money to spare regardless of what the govt says we can afford. In theory we are on expanded Medicaid in Oklahoma, but it's almost useless. I have not been able to use it even once in the last year except for RX. (Now for rx? That is great!) Because the few doctors on it aren't accepting new patients and even if we were to get on their waitlist, the wait to actually be seen is ridiculously long. We have been paying out of pocket as uninsured for every single doctor appoint this year because of one or both of those factors. On the plus side, we have gotten quicker and better care because of it, but hello debt and sad for those who just wait or do without or go to the ER. :/

Dh's last job offered insurance....we chose the high deductible (2500 per person, 5k per family). It was a miracle we had that insurance because twice in 6 months he had surgery....we now have about 3k in medical debt because those two surgeries fell in two different calendar years....but I am thankful we had it. That insurance cost us $300 a month. His new job where he is making 13k less a year offers insurance but he won't qualify until the end of November. I can't imagine the rate will be affordable. If it is $300 we could probably squeak by...anymore than that? Nope. Just can't do it.

 

On the one hand I am terrified of having no insurance ( our kids are covered)....and on the other hand I am like meh, it will be what it will be. My good friend was diagnosed 4 years ago next month with breast cancer. She had no insurance. I don't know the details but I know she was treated by various clinics and hospitals up to the very end. ( she died Tuesday).

 

I worry just as much if not more about dh not being able to work. No income would be worse than no insurance. I am going to stop borrowing worries. That is what my mom would recommend.

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I can't remember the last time I went to a doctor.  Was years ago.  We have relatively decent insurance, but I always feel like some of the stuff they do at the doctor's is a total waste of money and unnecessary.  I take the kids once a year for a physical.  The doctor always asks why they don't come in more often.  Because they are rarely sick and I don't run them there for piddly stuff like colds.  Growing up my mother ran us to the doctors for every piddly thing.  I think I went there 2x a month.  And for what?  It's gotten to the point that I'm totally turned off by the thought of having to go to a doctor. 

 

I took Hobbes to the doctor this week (recurrent knee pain) and she said, surprised, 'Oh, I don't think I know you.'  Our normal doctor has been ill himself and she came in to replace him about nine months ago.  I was surprised that she was surprised - we rarely go to the doctor, despite its being free.  

 

I check the boys height and weight myself.  They get immunisations with the nurse as scheduled.  Otherwise I only take them in if they have something that they really can't shake.

 

L

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Yeah that's a rather harsh cut off. This happens with taxes too. Sometimes a raise means being bumped up and you make less. It's rather stupid.

I don't want to contradict you if you are talking about how sometimes making more means, at a high level, your deductions are more limited and/or you qualify for the alternative minimum tax.

 

But I do want to say, because this is often misunderstood, that moving to a higher tax bracket does not mean all your money is taxed at the same higher rate. Only your earnings above the new cut off are taxed at the higher rate.

 

So, earning more just means you are paying a higher rate on the new, extra money, but paying the same rate as everyone else for the lower. Whether you make 40,000 or 400,000, that first 40,000 is taxed at the same rate. If I make 100,000 dollars one year and am in one bracket, but make 101,000 the next which pushes me to a higher bracket, I still pay the same old rates on the 100,000, and the higher rate only on the 1,000.

 

Of course it gets more complicated with loopholes, earned income credit, and deductions etc., but still I think it is good to know that rich people pay higher taxes on the money that they earn above what less rich earn, but they pay the same rate as those that earn less on the same money.

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I don't want to contradict you if you are talking about how sometimes making more means, at a high level, your deductions are more limited and/or you qualify for the alternative minimum tax.

 

But I do want to say, because this is often misunderstood, that moving to a higher tax bracket does not mean all your money is taxed at the same higher rate. Only your earnings above the new cut off are taxed at the higher rate.

 

So, earning more just means you are paying a higher rate on the new, extra money, but paying the same rate as everyone else for the lower. Whether you make 40,000 or 400,000, that first 40,000 is taxed at the same rate. If I make 100,000 dollars one year and am in one bracket, but make 101,000 the next which pushes me to a higher bracket, I still pay the same old rates on the 100,000, and the higher rate only on the 1,000.

 

Of course it gets more complicated with loopholes, earned income credit, and deductions etc., but still I think it is good to know that rich people pay higher taxes on the money that they earn above what less rich earn, but they pay the same rate as those that earn less on the same money.

 

Really? Oh my crapness....how did I not know this? THANK YOU. I needed this info today :)

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I was willing to subscribe to that theory until I read in the paper the other day that half of the country's uninsured will pay $57 a month and will receive tax credits. To me, that just gives the illusion that they are paying insurance.

 

But, you are right. We will not know until it happens. Like I said above, the thing that really scares me is that my dh's employer said that we will soon be paying 60% of his salary towards insurance. That seems unbelievable. I will be glad when I know what we are truly facing.

 

I think your dh's employer is using a scare tactic to try to convince employees to vote in a certain way.... without actually say it. I wouldn't believe the employer.

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That is shockingly high. :grouphug:

 

Unfortunately, it's "normal" now.  People have been posting for quite awhile about paying in excess of $1,000/month for insurance with deductibles in excess of $10,000.  I pay over $1,000/mo to have my family on my policy and our deductible is $7,000.  The full cost is more, but my employer pays my portion of the premium ($380/mo, I think?).

 

I checked the plans that BC/BS will offer on the exchange for NC, and the rates didn't seem to be much lower.

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FWIW, when the government was discussing Social Security the mood in the country was similar.  People thought that surely it was the worst idea ever and we would all go to hell in a hand bag.  I hope these changes help a lot of people and it isn't as chaotic as it is sounding now.

Hmmm, given the condition SS is in now, those people were probably right to be concerned.  But I agree with you that I hope it isn't as chaotic as it sounds now. 

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It's been like this for years for people who need to purchase individual insurance.  Before my husband got his job five years ago, we were dealing with 30% increases each year, so every year I had to reduce our coverage.  We started with a pretty good plan with a fairly low deductible and prescription coverage, and a few years later had ended up with a high deductible catastrophic plan and were paying more money for it.

 

After this experience, I honestly don't understand what is so offensive about universal health coverage.  We're already paying for other people's health care.  We pay for it in our insurance premiums, we pay for it in higher health care costs, and we pay for it in taxes.

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It's been like this for years for people who need to purchase individual insurance.  Before my husband got his job five years ago, we were dealing with 30% increases each year, so every year I had to reduce our coverage.  We started with a pretty good plan with a fairly low deductible and prescription coverage, and a few years later had ended up with a high deductible catastrophic plan and were paying more money for it.

 

After this experience, I honestly don't understand what is so offensive about universal health coverage.  We're already paying for other people's health care.  We pay for it in our insurance premiums, we pay for it in higher health care costs, and we pay for it in taxes.

 

Yes! We are already paying for it, we just don't admit it. Everyone who says the hospital just writes it off doesn't seem to realize that the rest of us are paying for that care by being charged more for our care.

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It's been like this for years for people who need to purchase individual insurance.  Before my husband got his job five years ago, we were dealing with 30% increases each year, so every year I had to reduce our coverage.  We started with a pretty good plan with a fairly low deductible and prescription coverage, and a few years later had ended up with a high deductible catastrophic plan and were paying more money for it.

 

After this experience, I honestly don't understand what is so offensive about universal health coverage.  We're already paying for other people's health care.  We pay for it in our insurance premiums, we pay for it in higher health care costs, and we pay for it in taxes.

 

Exactly. For every person who uses the ER as a dr's office and then stiffs them on the bill, they pass the charge onto the insurance companies to make up for it. We in turn pay more for insurance. If allowed to play out the insurance companies should lower rates because the overall cost of care will go down when bills are being paid. With the negative attitude about it I see a whole lot of jumping to conclusions by insurance companies and employers. That is their fault and lack of understanding at play.

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Thank you.  I tried it and it says a bunch of confusing stuff and does not address whether COBRA is considered insurance offered by the employer or not.  If it is, we are not eligible.  COBRA costs us big time per month and I don't know how long we can continue to pay.  I will have to research further.  

 

Staying on a COBRA plan only lasts 18 months under normal circumstances. It is only meant to tie you over until you find the next employer and insurance plan. Some plans will allow you to convert the group rate over to an individual rate at the end of the coverage. There are other circumstances for staying on longer or having coverage terminated.

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Staying on a COBRA plan only lasts 18 months under normal circumstances. It is only meant to tie you over until you find the next employer and insurance plan. Some plans will allow you to convert the group rate over to an individual rate at the end of the coverage. There are other circumstances for staying on longer or having coverage terminated.

Yes, I am aware of the usual length of COBRA.  My comment meant that I don't know if we can continue to afford to pay and I don't know how ACA will affect us.  I'm not sure what you are getting at here.   (But I am getting pretty tired, so maybe it's me.) I am still confused about what ACA is going to mean for us.  Apparently I am not alone.  

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Exactly. For every person who uses the ER as a dr's office and then stiffs them on the bill, they pass the charge onto the insurance companies to make up for it. We in turn pay more for insurance. If allowed to play out the insurance companies should lower rates because the overall cost of care will go down when bills are being paid. With the negative attitude about it I see a whole lot of jumping to conclusions by insurance companies and employers. That is their fault and lack of understanding at play.

I think Nancy Pelosi called these people "Free Riders" -- Forbes magazine published an interesting article addressing this.

 

http://www.forbes.com/sites/theapothecary/2011/02/02/myths-of-the-free-rider-health-care-problem/

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I'm so peeved, we are self-employed and we currently pay over $700 per month for a high deductible plan for our family of 4 and just found out that our insurance rates will go up 25%.  We also have a separate dental plan which we cannot change because we are in the middle of braces for both kids.  I am not sure how much that will go up.  This entire thing is just insanity -- I agree that the health care system is a mess, but when has government interference ever made something more effective or less expensive? 

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I'm so peeved, we are self-employed and we currently pay over $700 per month for a high deductible plan for our family of 4 and just found out that our insurance rates will go up 25%.  We also have a separate dental plan which we cannot change because we are in the middle of braces for both kids.  I am not sure how much that will go up.  This entire thing is just insanity -- I agree that the health care system is a mess, but when has government interference ever made something more effective or less expensive? 

 

I can relate.  From what I've seen so far we will lose our current plan and the new one will  cost us more than double what we currently pay in monthly payments and we will also have a $9000 deductible on top of that.  And unless I've misread the law, we won't be eligible for the exchange to get a better deal.

 

As far as the dental goes are you sure that's a problem.  We switched insurance twice during my son's braces and it had no bearing because only the one in effect when he first got them on paid their portion (which they did upfront), the remainder was left up to us to pay in payments.  Subsequent insurances wouldn't pay anything towards braces the were put on before the policy started  and the original had already fulfilled their part.

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I can relate.  From what I've seen so far we will lose our current plan and the new one will  cost us more than double what we currently pay in monthly payments and we will also have a $9000 deductible on top of that.  And unless I've misread the law, we won't be eligible for the exchange to get a better deal.

 

As far as the dental goes are you sure that's a problem.  We switched insurance twice during my son's braces and it had no bearing because only the one in effect when he first got them on paid their portion (which they did upfront), the remainder was left up to us to pay in payments.  Subsequent insurances wouldn't pay anything towards braces the were put on before the policy started  and the original had already fulfilled their part.

 

ugh, sorry you can relate to this garbage!  Yes, we talked to them today and our dental insurance pays $1000 toward braces, $500 at the beginning and $500 at the end.  If we don't stay with the insurance co. to the end, they don't pay that last $500 and the orthodontist will bill us for it, on top of the $4000 we already paid them up front.  It's all so fun.

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Am I understanding correctly that anyone can shop the exchanges, but unless employer offered healthcare is above 9.5% of income or doesn't pay 60% of certain costs you might not get the subsidy. But you still might get a tax break and better rates and coverage?

We have insurance for DS through the state, his dad doesn't provide it, I'm a sahm currently, and DH isn't able to insure just him. But DH and I have had to go without.

 

The plan DH company offered was over 500 a month in premiums for two healthy adults under 40. With an 10000 dollar deductible before they would pay a penny. No co-pays before that, no preventative care. And then they only covered at 70%, it also had a million dollar payout limit.

So we are talking about 20000 a year out of pocket expenses before they would cover anything.

 

We are at 185% of Federal poverty level, so not poor, but things are always tight. Always.

 

We are waiting for the new company info to come out,but I suspect we still won't be able to afford it.

 

I really hope there is a better option, we need insurance that is usable, but 9% of income spent on what amounts to little to no coverage is just not feasible.

 

The other thing that really bothers me is that we pay more for medicine and appointments than the insurance company. They have negotiated much lower rates so the cash paying patient is left paying more than the giant profit making corporation.

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 the cash paying patient is left paying more than the giant profit making corporation.

Make sure you are at least asking for the self-pay discount.  Some places give it automatically.  At other places you need to ask.  The "actual" rate we tend to pay as a cash customer (paid up front - or at the end of the appt) tends to be 70 - 75% of the normal rate.

 

I've no idea how that compares to insurance companies, but we've appreciated the break in cost.

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Am I understanding correctly that anyone can shop the exchanges, but unless employer offered healthcare is above 9.5% of income or doesn't pay 60% of certain costs you might not get the subsidy. But you still might get a tax break and better rates and coverage?

We have insurance for DS through the state, his dad doesn't provide it, I'm a sahm currently, and DH isn't able to insure just him. But DH and I have had to go without.

 

The plan DH company offered was over 500 a month in premiums for two healthy adults under 40. With an 10000 dollar deductible before they would pay a penny. No co-pays before that, no preventative care. And then they only covered at 70%, it also had a million dollar payout limit.

So we are talking about 20000 a year out of pocket expenses before they would cover anything.

 

We are at 185% of Federal poverty level, so not poor, but things are always tight. Always.

 

We are waiting for the new company info to come out,but I suspect we still won't be able to afford it.

 

I really hope there is a better option, we need insurance that is usable, but 9% of income spent on what amounts to little to no coverage is just not feasible.

 

The other thing that really bothers me is that we pay more for medicine and appointments than the insurance company. They have negotiated much lower rates so the cash paying patient is left paying more than the giant profit making corporation.

It is good that you qualify for your child to be insured . I would just wait and see what the exchange says. I don't think we have accurate info at all yet.

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My cousin just got her renewal statement. Here's what she posted about it on FB.

 

"I just got my renewal message from Group Health. My premiums are going up by about 85%, the deductible is increasing by 45%, and my out of pocket is increasing also. As far as I can see the only benefit that will increase, for me, will be that I get prescriptions covered, but only after I've paid the 4K deductible. I might just have to drop health insurance."

 

She lives in Washington State and is in her mid-forties. Single, no kids.

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We have BCBS Federal and I have been waiting for a letter since reading this thread and posts on Facebook. But I haven't gotten one yet. I did Google it, and found some articles saying that our rates are going up about 4%, really only a few dollars. Does anyone else have the same and hear/read something different?

 

Also, so, these exchanges.... They open on Tuesday? Where do you go to look at your options and pick a plan? My sister is low income and needs insurance. They don't have a computer, so I'd like to point her in the right direction. Is it some website, or something? I haven't paid attention to this stuff at all....

I take it you are under the FEHB (Federal Employees Health Benefit) system? Yes, I read that there will be a 4% increase for those under FEHB. A sweet deal if you ask me. I am speaking as a person who is currently under the FEHB, but was in the private industry for 20 years.

 

I wonder how much sympathy we will get when the government shut-down occurs if people consider what a nice deal we (Federal employees) get on health insurance.

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Make sure you are at least asking for the self-pay discount.  Some places give it automatically.  At other places you need to ask.  The "actual" rate we tend to pay as a cash customer (paid up front - or at the end of the appt) tends to be 70 - 75% of the normal rate.

 

I've no idea how that compares to insurance companies, but we've appreciated the break in cost.

 

In our state, it's illegal to charge people who don't have insurance less than you bill insurance companies.  The difference is that insurance companies have negotiated rates so they pay less than the bill, but the uninsured patient has to pay the whole thing.  Some doctors will code things differently for uninsured patients (Level III appt for the insured but Level I for uninsured), but they can't offer a discount or let the patient pay the same amount that an insurance company will pay.  Every time people always say that insured people are paying the bill for the uninsured, I think, nope, uninsureds who pay their bills are paying for the uninsureds who don't.  BCBS sometimes only pays 10% of a bill.

 

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